ROMAN POVOLOTSKIY MD
NPI 1225667355
Otolaryngology in Newark, NJ

Q: What is Roman Povolotskiy's NPI number?

The NPI number for Roman Povolotskiy is 1225667355. It was assigned to this individual provider in the NPPES registry on April 1, 2020.

Q: What is Roman Povolotskiy's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Roman Povolotskiy was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 01, 2020PECOS EnrolledAccepts Medicare Assignment

90 BERGEN ST STE 8100, NEWARK, NJ 07103(973) 972-2548 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 30, 2025, Apr 1, 2020 (2 updates tracked since 2020).

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About Roman Povolotskiy Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROMAN POVOLOTSKIY MD (NPI 1225667355) is an individual otolaryngology provider in Newark, New Jersey, licensed in New Jersey (25MA12473000) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Newark Beth Israel Medical Center, and maintains a secondary practice location in Mount Arlington.

NPPES Registry Identity

NPI1225667355

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameROMAN POVOLOTSKIYCredential: MD

Location Address90 BERGEN ST STE 8100Newark, NJ 07103-2425

Mailing Address400 Valley Rd Ste 105Mt Arlington, NJ 07856-2316 · (973) 770-7101

Phone(973) 972-2548

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateApril 1, 2020

Last NPPES UpdateJune 30, 20252 updates tracked since enumeration

NPPES CertifiedJune 30, 2025

✔ NPI 1225667355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in NJ · 25MA12473000

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

90 BERGEN ST STE 8100, Newark, NJ 07103

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Secondary Practice Location 1

Location 1400 Valley Rd Ste 105Mount Arlington, NJ 07856-2316 · Phone (973) 770-7101

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roman Povolotskiy Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567977416

PECOS Enrollment IDI20250711000805

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Newark Beth Israel Medical Center

Acute Care Hospitals · Newark, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310002

Location201 Lyons AveNewark, NJ 07112 · Essex County

Emergency services Birthing friendly

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310015

Location100 Madison AveMorristown, NJ 07960 · Morris County

Emergency services Birthing friendly

Saint Clare's Hospital/ Denville Campus

Acute Care Hospitals · Denville, NJ

3/5 CMS rating

OwnershipProprietary

CMS Certification Number310050

Location25 Pocono RoadDenville, NJ 07834 · Morris County

Emergency services Birthing friendly

Hackettstown Medical Center

Acute Care Hospitals · Hackettstown, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310115

Location651 Willow Grove StHackettstown, NJ 07840 · Warren County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$79.09 typical visit price

range $20.97 – $155.92

Typical copayment $19.77 (range $5.24 – $38.98)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AARON TUCKER MD

Student in an Organized Health Care Education/Training Program